Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
Predictors and Clinical Impact of Delayed Cerebral Ischemia After Aneurysmal Subarachnoid Hemorrhage: Analysis from China National Stroke Registry
First author：Wanying Duan
Corresponding author：Liping Liu
essential_information
- Person in charge：Wanying Duan
- Data Sources： CNSR-I
- Number of papers：CNSR-I20190235
- Published time：2017-10-19
2017-10-19
Published articles
Journal：CEREBROVASCULAR DISEASES
Publication type: Original Contributions
IF(IF): 2.762
PMID: 29049994 Link To Pubmed Full text Download
Background And Purpose
Introduction Delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH) is a significant cause of morbidity and mortality, the pre- dictive value of potential early factors is uncertain. This study aimed to identify independent predictors of DCI and clarify its clinical impact on patients’ outcome and disease course.
Method
This was a nationwide, prospective cohort study involving consecutive patients with aSAH recruited from the China National Stroke Registry. Univariate and multivariate lo- gistic regression were performed to identify predictors of DCI and evaluate the contribution of DCI to short- and long-term outcomes.
Conclusion
The occurrence of DCI after aSAH was independently predicted by sex, history of diabetes mellitus and poor clinical grade. DCI was associated with severe clinical course, poor outcome, and mortality both in short- and long-term of aSAH pa- tients in China.
Main results
The study included 504 patients with aSAH and 155 of them (30.8%) developed DCI. Among factors on admission, female (OR: 1.57; 95% CI: 1.05 to 2.36, p = 0.029), History of diabetes mellitus (OR: 2.31; 95% CI: 1.09 to 4.89, p = 0.030), Hunt and Hess grade 4–5 (OR: 4.46; 95% CI: 1.74 to 9.74, p < 0.001) and WFNS grade IV-V (OR: 3.66; 95% CI: 1.91 to 7.02, p < 0.001) were independent predictors of DCI. Patients with DCI was associated with high in-hospital complications including pneumonia (p = 0.006), cardiac arrhythmias (p = 0.002), gastrointestinal hemorrhage (p < 0.001) and urinary tract infection (p = 0.004), as well as high supporting interventions utilized rate (p = 0.006). DCI also contributed to poorer functional outcome and higher mortality at 3-, 6-, and 12-month.